Hc & Insurance Operations Associate

3 weeks ago

Chennai, India TekWissen Software Pvt. Ltd Full time

**Roles and Responsibilities**:

- Process Adjudication claims and resolve for payment and Denials
- Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process
- Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations
- Ensuring accurate and timely completion of transactions to meet or exceed client SLAs
- Organizing and completing tasks according to assigned priorities.
- Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team
- Resolving complex situations following pre-established guidelines

**Requirements**:

- 1-3 years of experience in processing **claims adjudication and adjustment process**:

- Experience in **professional (HC), institutional (UB) claims (optional)**:

- Good communication (Demonstrate strong reading comprehension and writing skills)
- Able to work independently, strong analytic skills
- Experience into **Authentication & pre - authentication**:

- Experience in **Member eligibility criteria.**

**Job Types**: Full-time, Regular / Permanent

**Salary**: Up to ₹26,000.00 per month

**Benefits**:

- Cell phone reimbursement
- Health insurance
- Provident Fund
- Work from home

Schedule:

- Monday to Friday
- Night shift

Supplemental pay types:

- Shift allowance

Ability to commute/relocate:

- Chennai, Tamil Nadu: Reliably commute or planning to relocate before starting work (required)

**Education**:

- Bachelor's (required)

**Experience**:

- total work: 1 year (required)

**Speak with the employer**
+91 9490924018
Application Deadline: 20/02/2023
Expected Start Date: 24/02/2023

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